Ok, so I am in my final semester of nursing school
and with some limitations, am expected to function almost independently in the RN role. So I had a patient the other day who is in the late stages of AIDS. HE is very ill and understandably cranky. I don't take it personally because I know it's not about me. Well, the other day, he rang the call light and asked me for juice.. The room reeked of cigarette smoke. He is on the nicotine patch and he is also on O2 therapy. All I said was, " It smells like smoke in here, " When I came back with his juice he started screaming at me. HE told me he didn't want to see me the rest of the night and to get the f--- out of his room. I said calmly, " I'm just asking you to not smoke in here. You know better," and I left the room. Well, the charge nurse nurse yelled at me in front of the entire floor and accused me of antagonizing him. She said, " Don't push his buttons when he is not feeling well," I don't think I was being antagonistic. Should I have just allowed him to continue smoking. What if he wanted to smoke crack? Should I have let him because he didn't feel well? I didn't make a big deal out of the smoking...I merely asked him to stop. The patient afterward proceeded to throw himself on the floor and have a tantrum and the charge nurse proceeded to coddle him. After she left, the patient reverted to his normal nasty self and screamed obscenities at everyone. HE threw all of the nurses out of his room and he was even abusive to his own family. I never went back to his room that night, because I didn't want to further agitate him. I know he is dealing with a lot of issues right now so I didn't take his behavior to heart. I was more upset that the charge nurse yelled at me. Was I wrong to ask a man on O2 therapy and a nicotine patch not to smoke? He is terminally ill and a DNR. He has been refusing almost all treatment. I wonder if he may be better off in a hopsice setting at this point? Maybe they could provide better comfort measures than we can? I don't know. Can I have some feedback?